Examples of Alternate Contact Name in a sentence
Total Number of Vessels:*(covered by permit) Business Name:* Email Address:* Mailing Address:* City* State* Zip Code* Business Phone #*: Mobile #* Mobile Accepts Texts:(used only when needed) Mobile Service Provider:(AT&T, Verizon, T-Mobile, etc.) Business Contact Name:* Alternate Contact Name: FAX #: The following permit conditions apply to those using the waters at Kealakekua Bay State Historic Park (KBSHP) (conditions subject to change):1.
Alternate Contact Name (you may choose to provide a Property Manager’s name)A.12.
Company Name: Address: Contact Name: Title: Alternate Contact Name: Title: Phone: Email: Description of Work:Service Dates: Company Name: Address: Contact Name: Title: Alternate Contact Name: Title: Phone: Email: Description of Work:Service Dates: Company Name: Address: Contact Name: Title: Alternate Contact Name: Title: Phone: Email: Description of Work:Service Dates: ATTACHMENT 3: DISCLOSURE / CONFLICT OF INTEREST STATEMENT Offeror: The award hereunder is subject to the Texas Workforce Commission FMGC.
Program Management: 0BLicensee Primary Alternate Contact Name Organization Address Phone Number Tel.
ALTERNATE CONTACT INFORMATIONComplete this section to provide an alternate contact in the event the recipient and LRI are unavailable.• Alternate Contact Name – Enter the name of the alternate contact person.• Phone – Enter the alternate contact person’s phone number.• Relationship to Recipient – Enter the contact person’s relationship to the recipient.• Can this person be contacted in case we are unable to contact recipient – Indicate yes or no.
If Family has NO Medical Insurance, write “NONE.” In case of emergency, notify: F/ L Name: Relationship: Home Phone: Work Phone: Cell Phone: Alternate Contact Name: Phone No.: MEDICAL HISTORY:Are you now, or have you ever been treated for any of the following:YesNo Last Name: DOB: Page 2 of 3ALLERGIES OR REACTION TO: Medications: Food: Other: IMMUNIZATIONS:The following are recommended.
Please describe the DSCSA services your organization provides and/or your relevant expertise (1-3 sentences): * Primary Representative Name * Title * Email *Phone Number *Area Code Phone Number Alternate Contact Name * Title * Email * Phone Number *Area Code Phone Number PDG is a balanced, independent, sector-neutral forum committed to advancing the interoperable tracing and verification of U.S. pharmaceuticals pursuant to the Drug Supply Chain Security Act of 2013.
Alternate Contact Name (First, Last) Relationship to the Main Applicant Agency/Shelter Name (if applicable) Address and Telephone Number:Street NumberStreet NameApt/Unit Number Postal CodeCity/TownProvince Telephone Number Current Housing Questionnaire If you are living in a shelter or on the streets, let us know and verify your living circumstances.
Orders and payments should be addressed to: Blak Lava, LLC8229 Boone Boulevard, Suite 801B Vienna, VA 22182 Contact Name: Arrash Rezvan Alternate Contact Name: Ken Coleman Contractor must accept the credit card for payments equal to or less than the micro- purchase for oral or written orders under this contract.
XXX AGREEMENT --------------------- This XXXXXXX.XXX AGREEMENT ("Agreement") is made and entered into as of August 15th 2006 ("Effective Date"), by and between DataCall Technologies, Inc.